Podcast #52: Syphilis the Great Imitator

Run Time: 7 minutessyphilis-hands

Author: Dr. Donald Stader

Educational Pearls:

  • Syphillis is a very important historical and current disease. The study of Syhpillis or “Syphilology” evolved into the field of dermatology.
  • Syphilis, an is caused by the spirochete bacteria, Treponema pallidum
  • Syphilis comes in three stages: primary, secondary, and tertiary stages.
  • In the primary stage, they develop a canker that is a painless ulcerative lesion on the genitals, mouth or anus and resolves over time.
  • In the next few weeks you begin the secondary stage of syphilis marked by the development of a rash – that can  mimic any rash except those with vesicles – classically it involves the hands and soles of the feet.
  • The tertiary stage occurs over many years, it has many manifestations including neurosyphilis – which can cause psychosis, dementia or even stroke symptoms. People with tertiary stage syphilis also develop a proximal aortic aneurysm, called a “leutic aneurysm” causing aortic regurgitation. This has a ton of clinical signs and can manifest in the bouncing of someones head, pulsating hands, and blushing of nail beds with each beat of the heart. Tertiary stage syphilis can also cause hepatitis and even give people “gummas”, which are rubbery lesions to peoples skin. Bottom line – Syphillis causes a ton of symptoms and has been called the “Great Imitator” as a result.
  • Treatment of syphilis is penicillin, which is the best antibiotic to treat the infection. Depending on the stage and length of time the person has had syphilis dictates how long of a treatment regimen they will be placed on.
  • For those allergic to penicillin with neurosyphilis, people can undergo a process of developing anergy to be able to tolerate penicillin. This is usually done in conjunction with an immunologist.
  • In the United States, Baltimore and Louisiana have higher rates of syphilis than the rest of the country.

Link to Podcast: http://medicalminute.madewithopinion.com/syphillis-the-great-imitator/

References: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC88914/

For your intrigue: http://www.theatlantic.com/health/archive/2015/12/the-return-of-syphilis/418170/

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